INSPECTION MADE BY PROGRESS OF WORK TIME ELAPSED WORK COMPLETED Unsatisfactory Unsatisfactory Satisfactory Satisfactory QUALITY OF WORK IN COMPANY WITH (Name, Title) (Check appropriate box) Process Review / Product Evaluation Phase (Inspection-in-Depth) Project Final LOCATION: (fill in the blank) PROJECT DESCRIPTION/WORK TYPE: (fill in the blank) PROJECT INFORMATION: (Acquire a copy of Contract Award Summary once at the beginning of the project) CONTRACTOR (Name) (Address) (City) (Phone) CONTRACT AMOUNT ( 9999) STATE CONTRACT OR EA NO.. (99-999999) AREA ENGINEER (Name) (Address) (City) (Phone) (Fax) (E-mail) CONTRACT TIME SUMMARY: (Acquire a copy of Weekly Statement of Working Days Progress Payment Voucher after each construction inspection) STATUS OF CONTRACT TIME AS OF (MM/DD/YYYY) CONTRACT AWARDED (MM/DD/YYYY) FIRST WORKDAY (MM/DD/YYYY) ESTIMATED COMPLETION DATE (MM/DD/YYYY) WORKING DAYS IN CONTRACT (99) TIME EXTENSIONS (99) NON-WORKING DAYS (99) REVISED WORKING DAYS (99) TOTAL WORKING DAYS TO DATE (99) REMAINING WORKING DAYS (99) Note: If a CCO is non-participating then days are non-participating.. Tie bars checked for proper: Spacing Bar Size Installation o Multi-piece: few visible threads showing (require pull out testing if too many visible) o Single-piece: pull-out testing performed hole cleaned using approved epoxy correct epoxy usage (amount remaining in hole, time, temperature) o Single-piece fresh immersion: no edge slump pull-out testing performed 22.. OE inspectors are collecting and reviewing concrete tickets to determine: Concrete is from an approved mix design Mix design has trial batch results supporting slump loss for duration of pour will be acceptable Correct class of concrete w/c is maintained Signature of TxDOT Observer Observation Date TxDOT Process for Acceptance of Concrete Structures Built and Inspected by Other Entities = Acceptable MD = Minor Deviations X = Unacceptable NA = Not Relevant (Use check box to indicate if do
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